Why randomised trials still work best

The only thing separating reiki and reflexology from rational medicine and progress is evidence. And what evidence-based aficionados like me love best is the randomised controlled trial, the process by which most drugs and treatments aspire to be tested. But are we now hearing its death rattle?

In a recent lecture at the Royal College of Physicians, Professor Sir Michael Rawlins appeared to have stuck the knife in the randomised controlled trial. Sir Michael, chairman of the National Institute for Health and Clinical Excellence, effectively said that such trials weren’t the be-all and end-all. “Sir Michael Rawlins attacks traditional ways of assessing evidence”, the story went. But it is not the value of these trials that is the problem, but rather how we chose to think about their conclusions.

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